HomeMy WebLinkAboutPermit M11-147 - MIRACLE EARMIRACLE EAR
674 STRANDER BL
Mi 1 -147
City olkukwila
•
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Inspection Request Line: 206 - 431 -2451
Web site: http: / /www.TukwilaWA.gov
MECHANICAL PERMIT
Parcel No.:
Address:
674 STRANDER BL TUKW
Project Name: MIRACLE EAR
Permit Number: M11 -147
Issue Date: 10/06/2011
Permit Expires On: 04/03/2012
Owner:
Name:
Address:
Contact Person:
Name: GERALD UTLEY
Address: 719 116 ST SE , EVERE T WA 98204
Email: N/A
Contractor:
Name: ARM & HAMMER CONSTRUCTION
Address: 10718 10 DR SE , EVERETT WA 98208
Contractor License No: ARMHAHC902OZ
Phone: 425 381 -9153
Phone: 425 - 381 -9153
Expiration Date: 09/09/2012
DESCRIPTION OF WORK:
REDIRECTING VENTS /DIFFUSERS
Value of Mechanical: $1,500.00
Type of Fire Protection: UNKNOWN
Electrical Service Provided by:
Permit Center Authorized Signature:
I hereby certify that I have read and
governing this work will be complie
Fees Collected: $209.63
International Mechanical Code Edition: 2009
Date:
ed this permit and know the same to be true and correct. All provisions of law and ordinances
hether specified herein or not.
The granting of this permit does not pr
construction or the performance of work.
back of this permit.
to give authority to violate or cancel the provisions of any other state or local laws regulating
authorized to sign and obtain this mechanical permit and agree to the conditions on the
Signature:
Print Name: ( 2_ .4042 17. 1�j�,(L�J
This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended
or abandoned for a period of 180 days from the last inspection.
Date: /l / %a /'/
doc: IMC -4/10
M11-147 Printed: 10 -06 -2011
• •
PERMIT CONDITIONS
Permit No. M11-147
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the
Building Official.
3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to
start of any construction. These documents shall be maintained and made available until final inspection approval is
granted.
4: Manufacturers installation instructions shall be available on the job site at the time of inspection.
5: Except for direct -vent appliances that obtain all combustion air directly from the outdoors; fuel -fired appliances
shall not be located in, or obtain combustion air from, any of the following rooms or spaces: Sleeping rooms,
bathrooms, toilet rooms, storage closets, surgical rooms.
6: Equipment and appliances having an ignition source and located in hazardous locations and public garages, PRIVATE
GARAGES, repair garages, automotive motor -fuel dispensing facilities and parking garages shall be elevated such that
the source of ignition is not less than 18 inches above the floor surface on which the equipment or appliance rests.
7: Water heaters shall be anchored or strapped to resist horizontal displacement due to earthquake motion. Strapping shall
be at points within the upper one -third and lower one -third of the water heater's vertical dimension. A minimum
distance of 4- inches shall be maintained above the controls with the strapping.
8: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the City of Tukwila
Building Department (206- 431 - 3670).
9: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building
Department (206- 431 - 3670).
10: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of,
any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits
presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila
shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the
Building Official from requiring the correction of errors in the construction documents and other data.
doc: IMC -4/10
M11 -147 Printed: 10 -06 -2011
CITY OF TUKW
Community Development Department
.Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http: / /www.TukwiIaWA.gov
Mechanical Permit No.
Project No.
(For office use only)
MECHANICAL PERMIT APPLICATION
Applications and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or by fax.
* *please print **
SITE LOCATION
Site Address:
471Y -71,A17.
Tenant Name: ;�%% .fi t° r
King Co Assessor's Tax No.:
Suite Number: Floor:
New Tenant: ❑ Yes ❑..No
Property Owners Name:
Mailing Address:
City
State
Zip
CONTACT PERSON — who do we contact when your permit is ready to be issued
Name: (-200.4.../1 !/ ?.(7
Mailing Address: // 7 S-1 -( f
Day Telephone: 17/-2,--- 3 2- 4 '7/
City
E -Mail Address:
State
Zip
Fax Number:
MECHANICAL CONTRACTOR INFORMATION
Company Name: Mice, 13/A2'm
Mailing Address: 7 /J" /72 Z . S'T Y.�/1�7-�- �� 5'.ZD,49"
Contact Person: 4P4 { 7 4" Fq
E -Mail Address: Fax Number:
/
Contractor Registration Number: t'� 1�1 V \ Yf, (1 6102- Pk Expiration Date:
City State Zip
Day Telephone:
b1
ARCHITECT OF RECORD — All plans must be stamped by architect of record
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
Fax Number:
E -Mail Address:
State
Zip
ENGINEER OF RECORD — All plans must be stamped by engineer of record
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
State
Zip
H:\Applications\Forms- Applications On Line \2010 Apphcations \7 -2010 - Mechanical Permit Application.doc
Revised: May 2011
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Page 1 of 2
Valuation of project (contractor's bid price): S ,,pp
Scope of work (please provide detailed information): 4!,
Use: Residential: New ❑ Replacement ❑
Commercial: New ❑ Replacement ❑
Fuel Type: Electric ❑ Gas ❑ Other:
Indicate type of mechanical work being installed and the quantity below:
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Bioler /Compressor
0 -3 hp /100,000 btu
Qty
furnace <100k btu
air handling unit
>10,000 cfrn
fire damper
furnace >100k btu
evaporator cooler
diffuser
3 -15 hp /500,000 btu
floor furnace
ventilation fan connected
to single duct
thermostat
15 -30 hp /1,000,000
btu
suspended/wall/floor
mounted heater
ventilation system
wood/gas stove
30 -50 hp /1,750,000
btu
appliance vent
hood and duct
emergency
generator
50+ hp /1,750,000 btu
repair or addition to
heat/refrig/cooling system
Incinerator — domestic
other mechanical
equipment
air handling unit <10,000
cfm
incinerator — comm/ind
PERMIT APPLICATION NOTES -
Value of construction — in all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the permit center to comply with current fee schedules.
Expiration of plan review — applications for which no permit is issued within 180 days following the date of application shall expire by limitation.
The building official may grant one extension of time for additional periods not to exceed 90 days each. The extension shall be requested in writing
and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition).
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OR A ORIZED AGENT:
Signature: i1. / ;
Print Name: 6,ge.P th
Mailing Address: 1/5' //1r4. .3
I Date Application Accepted: Oleo[ p `I
Date: A, 06/2.0//
Day Telephone: ca-59
City
9�zgh
State Zip
Date Application Expires:
H:1Applications\Forms- Applications On Line \2010 Applications17 -2010 - Mechanical Permit Application.doc
Revised: May 2011
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Staff Initials: t!/
age 2 of 2
• •
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206-431-3665
Web site: http: / /www.TukwilaWA.gov
Parcel No.:
Address: 674 STRANDER BL TUKW
Suite No:
Applicant: MIRACLE EAR
RECEIPT
Permit Number: M11 -147
Status: APPROVED
Applied Date: 10/06/2011
Issue Date:
Receipt No.: R11 -02192
Initials: JEM
User ID: 1165
Payment Amount: $167.70
Payment Date: 10/06/2011 11:32 AM
Balance: $0.00
Payee: GERALD M UTLEY
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 1661 167.70
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
MECHANICAL - NONRES
000.322.102.00.00 167.70
Total: $167.70
doc: Receipt-06 Printed: 10 -06 -2011
INSPECTION RECORD
r 147 Retain a copy with permit Pt( (
PERMIT NO.
CITY OF' TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670
'Permit Inspection Request Line (206) 431 -2451
Project: 1, 4� ! a %
j(�iJ
Type jopf�i�neectign: ��
!w� _l /-�
}�
l•
Address:
Date Called:
Special Instructions:
Date Wanted:.
(p -7.� �'
1
!
1-.I
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p.m.
Requester:
Phone No:
•
ElApproved per applicable codes. D Corrections required prior to approval.
COMMENTS:
Ct) kt t>i?
P
Inspec
/tom
IDat /0
REINSPECTION FEE REQUIR
paldat 6300 Southcenter Blvd.
. Prior to next inspection. fee must be
. Suite 100. Call to schedule reinspection.
•
•
INSPECTION RECORD
• Retain a copy with permit
INS.RECTtON NO. PERMIT NO.
• CITY OF TUKWILA BUILDING DIVISION
.6300.Southce.nfer..B'Ivd., #100, Tukwila. WA 98188 (206) 431 -3670
'Permit Inspection Request Line (206) 431 -2451
MII -1411
Project:
Type of Inspection:
In'
t)
Address:
Date Called:
Special instructions:
s•
• -
••
Date Wanted:.
,
6 —(F—l(
a.m.
p.m.
Requester:
Phone No:
Approved per applicable codes. Corrections required prior to approval.
•
COMMENTS: -
Insp ctor:
Date:
1 0 _+�,'
REINSPECTI.ON FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Contractors or Tradespeople Per Friendly Page
•
General /Specialty Contractor
A business registered as a construction contractor with L &I to perform construction work within the scope of
its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of
account and carry general liability insurance.
Business and Licensing Information
Name ARM & HAMMER CONSTRUCTION UBI No. 601532321
Phone 4253819153 Status Active
Address 10718 10Th Dr Se License No. ARMHAHC9020Z
Suite /Apt. License Type Construction Contractor
City Everett Effective Date 9/9/2010
State WA Expiration Date 9/9/2012
Zip 98208 Suspend Date
County Snohomish Specialty 1 General
Business Type Individual Specialty 2 Unused
Parent Company
ther Associated Licenses
License
Name
Type
Specialty
1
Specialty 2
Effective
Date
Expiration
Date
Status
RAMEXI'991BU
RAM
EXTERIORS
INC
Construction
Contractor
Siding
Carpentry/Framing
1/31/2001
1/1/2002
Archived
PJINTI'011BD
P J
INTERPRIZE
INC
Construction
Contractor
General
Unused
1/4/1999
12/31/2003
Archived
PJINT**065D1
P J
INTERPRIZE
Construction
Contractor
Siding
Carpentry/Framing3
/21/1994
3/15/1999
Archived
Business Owner Information
Name
Role
Effective Date
Expiration Date
UTLEY, GERALD MATTHEW
Owner
09/09/2010
Bond Amount
Bond Information
Page 1 of 1
Bond
Bond Company Name
Bond Account Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Bond Amount
Received Date
2
Western Surety Co
61128005
09/07/2011
Until Cancelled
$12,000.0009/02
/2011
1
American Contractors
Indem CO
100138220
09/07/2010
09/07/2011
$12,000.0009/09
/2010
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
Insurance
Company Name
Policy Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Amount
Received Date
3
Nevada Capital
Ins Co
77NPP4014879
09/07/2011
09/07/2012
$1,000,000.0009
/14/2011
2
Nevada Capital
Ins Co
77NPP4014879
09/01/2011
09/01/2012
$1,000,000.00
09/02/2011
1
Nevada Capital
Ins Co
NCIC000926
09/07/2010
09/07/2011
$300,000.00
09/09/2010
Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period
Warrant Information No unsatisfied warrants on file within prior 6 year period
https://fortress.wa.gov/lni/bbip/Print.aspx
10/06/2011